HuffPo Offers Vet Woo Too, Courtesy of Dr. Palmquist

The folks at Science-Based Medicine and Respectful Insolence have been pointing out for a while that the Huffington Post has become a mainstream media champion for unreliable alternative medical information. And fortunately for us, HuffPo isn’t ignoring the veterinary side of alternative medical propaganda. Dr. Richard Palmquist, President-Elect of the American Holistic Veterinary Medical Association (AHVMA), of which I recently ran afoul, contributes a column to HuffPo. His latest commentary is instructive in that it illustrates the free mixing of reasonable ideas and science with nonsense made up out of thin air, in order to make the two indistinguishable and paint opinion and unsupported belief with a patina of scientific respectability.

Scientists are pretty smart, but give them a bucket of carbon, oxygen, hydrogen, sulfur, iron, nitrogen and a few other miscellaneous things and see how many tomatoes they can make from scratch.

Nature is smarter.

Of course, scientists can’t whip up rattlesnake venom, syphilis, hookworms, tsunamis, or many other natural phenomena from scratch either. What’s the point here? If it is that what nature comes up with is better than what humans can make, I think that’s childish reasoning. “Nature” is just our personification of impersonal and undirected processes that have resulted in everything that exists, including human beings and their inventions, and it cares not a whit for our happiness and well-being. We like to say nature makes the good stuff, like puppies and strawberries, and we make all the toxic waste, but the reality is that nature made polio and we made the vaccine, so sometimes we are the good guys..

Dr. Palmquist then proceeds to make the true and quite reasonable observation that many useful medicines come from plants. Of course, this requires humans to analyze, purify, process, mimic, and test all sorts of compounds to find a few useful ones, none of which come without drawbacks, so how natural or inherently benign all of this is open to question. In any case, he inserts another assumption into this otherwise reasonable point, namely that the plants that contain substances useful as medicines were identified as medicinal and used to heal diseases by folk traditions a long time before science stumbled across their usefulness.

I am not aware of any evidence to support this notion, though it is commonly put forward by advocates of herbal remedies and traditional folk medicine in general. It may be true, but there are several reasons why I am doubtful of this assertion and would like something more than herbalists’ word for it. Prominent among them is confirmation bias, the tendency to focus on those examples which support one’s position and ignore those that don’t.

1. Many pharmaceuticals derived from plants, animals, fungi and other natural sources are discovered for reasons not related to folk medicine use. Someone notices that mold in a petri dish inhibits bacterial growth near it, and penicillin is discovered. Scientists work out that blowfish toxin paralyzes muscles and the chemical turns out to be useful in surgery. There are lots of reasons why a particular compound is pursued as a possible medicine apart from its traditional folk medicine use.

2. Most of the folk remedies one can find in historical documents turn out not to work reliably when tested, so Dr. Palmquist is guilty of counting the “hits” and ignoring the “misses.” If folk tradition were a reliable guide to which plants have medicinal value and which don’t, then the plants used in folk traditions should turn out to produce useful medicine more often and more reliably than those not so used. I have seen no evidence investigating this questions, so while it is possible it is by no means safe to assume it is true.

3. Almost every plant has been identified by some culture at some place and time to have medicinal properties. And when these properties are described, the plants are often said to treat a huge number of unrelated symptoms and diseases. When a plant turns out to contain a substance useful for a particular medical problem, one can almost certainly find a reference somewhere to that plant being used for that problem. This ignores the fact that the vast majority of claims made in traditional use of plants are either untested or shown to be untrue, so again Dr. Palmquist is cherry picking the examples where someone somewhere guessed right and ignoring all the wrong guesses.

4. As the post properly points out, getting medicines from plants almost always requires isolating, purifying, and altering chemicals to get better efficacy and fewer side effects. Most compounds investigated as possible drugs fail because they do more harm than good, or no good at all, and those that do succeed are often quite different from what one gets when eating plant parts directly. But Dr. Palmquist persists in putting forward the notion that a mixture of chemicals found in nature is likely to be safer and more effective than isolated and processed compounds. The evidence of medical history is soundly against this idea.

Certainly, it is true that combinations of medications are often more effective than single medications in managing complex diseases. But these are combinations of individual agents that are well-studied and understood and that have demonstrable benefit alone as well as in combination. And the sad reality is that combinations of drugs often leads to drug interactions which can be harmful. Dr Palmquist can say that Vitamin E is synergistic with NSAIDs for cancer therapy, but it is also true that Vitamin C diminishes the effect of some cancer treatments, so he is again picking examples that support his point and ignoring those that do not.

So why should we believe that the combination of chemicals found in a plant was somehow designed by nature to be ideal for treating a disease? Why should we think the combinations of plant ingredients created by folk medical traditions, arrived at either by uncontrolled trial and error or often fantastical theories based on religion, astrology, sympathetic magic, and so on, should be safer and more effective than medicines tested scientifically? Especially given the far greater success of medical science at treating diseases than any previous system has achieved in human history. And how do we explain the contamination of herbal remedies with toxins or even prescription drugs?[see references below] Dr. Palmquist answers none of these concerns but simply blithely assumes that what is natural and traditional is likely to be better than what is manmade and science-based.

There is no doubt nature, which after all describes everything that exists unless one arbitrarily chooses to exclude humans and their activities, holds many medical therapies yet to be discovered. But there is significant doubt that these therapies have already been identified in their safest and most effective form by herbalists and other folk medicine traditions. The reality is that science has taken not only the theories of these traditions but many other ideas they never conceived and created a wealth of medicines undreamt of before the age of scientific medicine. So to say nature knows best is at least naïve and at most an ideological even religious statement of faith rather than a scientific statement of fact. Dr. Palmquist is entitled to his faith like the rest of us, of course, but it should be clearly identified as such, not put forward by HuffPo as if it were established, accepted science.

Like the other blogs, it would be fun to dedicate a weekly dose of Huff-“Poo” here if they’re talking about vet med. The current vet article you linked from there, for example.

If you decide to dedicate such articles, can you also make mention that it is obvious that HuffPo has no intention of allowing challenging posts. (I tried, didn’t even challenge, just asked a simple question, guess that’s asking too much).

I have added Dr. Palmquist’s blog to my list of alt med blogs I scan, and I will try to respond to soem of his posts when it seems appropriate. The major purpose of this site is to provide an alternative to the misiniformation and a voice of caution and skepticism against all the blind enthusiasm for unproven veterinary treatments, so even though I can’t compete effectively with the many, mnay woo-friendly sites out there, I will keep tilting!

I love this blog, skeptvet, every article is something new and virtually unexplored elsewhere, at least in terms of skeptical veterinary sites. I feel as though I’m getting additional education here!

One of the articles on HuffPo, seems a common theme among alt med practitioners: treating cancer with homeopathy, supplements and other woo. If I may kindly request, would you consider an article on this sometime in the future to dispel some of the woo myths? I know you’ve touched on this on occasion but an in-depth article would be so refreshing!

Ellen,
Presumably you offered those links as examples of potential drugs being identified based on folk traditiona, as Dr. Palmquist argues they are. So here’s an example of how it is more commonly done (and from HuffPo, no less!):

Dueling examples doesn’t, of course, prove anything. What percentage of drugs are discovered thanks to hints provided by folk tradition I don’t know, and I don’t think anyone else knows either. I suspect it is a tiny proportion, especially given that the practices described in the article linked to above are the norm these days. Drugs are mostly discovered by first understanding the disease we wish to treat and what sorts of interventions might be helpful and then testing large numbers of substances, based on reasoning from chemistry and pharmacology, that might fit that purpose. Very few are found by testing to see if folk beliefs about medicinal plants are true or not.

The important point is that accepting the validity of untested herbal remedies based on the logic that a few of these remedies have led to the discovery of scientifically proven medicines is not jsutified, and is more likely to lead to acceptance of ineffective or unsafe products than following the guide of real scientific methods and evidence.

skeptvet, i agree with your main points, especially about untested over-the-counter herbal remedies, but i do think there are strengths in the ethnobotanical approach to pharmaceutical drug discovery. btw, thanks for the links. the pharmaceutical product development (ppd) website is very interesting.